ireland

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99 murder, manslaughter or infanticide, both before - a coroner, on the one hand, and before examining justices and assize courts on the other. The coroner " in the absence of reason to the contrary," is to adjourn his inquest " until after the conclusion of the criminal proceedings." The clerk of the appro- priate court is to inform the coroner of the result of those proceedings and, if the coroner then decides not to resume the inquest, the coroner furnishes the registrar of deaths with a certificate stating the result of the proceedings and including any necessary particulars. An inquest was begun last year upon the death of a child. The magistrates committed the child’s mother to the November Assizes on a charge of wilful murder. The coroner apparently adjourned his inquest as directed by the 1926 Act. The next step, however, contemplated by the statute cannot be taken. The Home Secretary has ordered the woman’s removal to an asylum : she will now not be tried, and consequently the " proceedings " cannot be "concluded " with any " result " of which the coroner can be officially informed. Thus, it would seem, the inquest must take its course. The coroner has found himself obliged to issue a warrant against the mother, bind over the police superintendent to prosecute, and bind over the witnesses to appear and give evidence. It would have been feasible to take the poor woman to the assizes for the formal purpose of obtaining a verdict of " Guilty, but insane." Quite apart from the expense of this course, however, public opinion would deprecate it. An Unregistered Dental Association. A case was recently heard before the Oldham borough justices in which a manager of the Co-operative Wholesale Society (Health Insurance Section) was summoned for " practising or holding himself out to practise dentistry," his name not appearing in the Dentists Register. It was argued on behalf of the British Dental Association that it was not essential for the commission of an offence of this kind, that the person should be the actual one who performed the operations of dentistry. A body corporate or limited company could carry on dentistry if the majority of its directors and all its operating staff were dentists, though not otherwise. It was stated that the C.W.S., being an approved society under the Health Insurance Acts, had not agreed to an increase in the scale of dentists’ fees in 1926, and despite the fact that it was not a registered organisation under the Dentists Act, had endeavoured to set up dental clinics in certain northern towns. An unregistered dental surgeon had been given charge of such a clinic at Oldham where there was a clerk and four dental mechanics, and patients had been treated there on behalf of the Co-operative Dental Benevolent Association, which was unregistered under the Act. In defence counsel argued that responsibility for what had been done lay with the Association and not with its salaried manager. The chairman and the bench were of opinion, however, that the latter had unlawfully held himself out as practising dentistry and fined him £50, also awarding JB25 costs to the prosecution. They agreed to state a - case for appeal to the High Court. Two Deaths Under Ancesthesia. Arrangements at the Weir Hospital, Balham, were criticised at an inquest on Jan. 2nd on a boy of 4 who died in the institution whilst a fracture of the leg was being reduced under an anaesthetic. There are two resident doctors at the hospital but one of them was away when the child was brought for treatment. The resident medical officer first adminis- tered open ether and then instructed a nurse to hold the mask while he reduced the deformity. ’Death followed from heart failure, despite employ- ment of artificial respiration and stimulants, and at autopsy it was found that the boy had a full stomach which adhered abnormally to the liver. The coroner, m recording a verdict of death by misadventure, said that the resident medical officer had exercised careful judgment in the circumstances, was justified in administering the anaesthetic, and did so properly. At the same time he considered it distinctlv inadvisable that the hospital should be left with only one doctor, since only in grave emergency should a medical man play the dual part of anaesthetist and surgeon. It was stated in evidence that the hospital had two visiting surgeons, but it was not customary to call them in except for big operations. On Jan. 8th the Westminster coroner recorded a similar verdict in the case of a boy of 2 who died during an operation at Charing Cross Hospital. Post mortem large pieces of undigested food were found in the stomach and the pathologist, in ascribing death to syncope, said that the presence of food was probably in part responsible for the accident. The mother said she had not received any instructions about meals, and the doctor who gave the anaesthetic said that she (the doctor) had not seen the child on any previous occasion. The anaesthetic was ethyl chloride, followed later by a mixture of chloroform and ether. The coroner remarked that he thought it was the common practice in hospitals to warn parents not to give their children meals a few hours before anaesthetics would be administered. IRELAND. (FROM OUR OWN CORRESPONDENT.) Study Leave. THE refusal of the Minister of Local Government and Public Health to sanction the proposal of the Grangegorman Mental Hospital Committee to give one of their medical officers six months’ study leave with pay has given rise to criticism. As was pointed out by a member of the committee, the institution would benefit by the course of study which Dr. J. Dunne proposed to pursue. Another member men- tioned that the Minister of Defence had thought it wise to send young officers to study the methods of foreign armies. The lack of any provision for study leave is a grave fault in the public medical services of the Irish Free State. The Committee of Inquiry on National Health Insurance and the Medical Services in its Interim Report in 1925 made a strong recom- mendation in favour of the grant of study leave at regular intervals to dispensary medical officers. It was recommended that a period of not less than three months should be given at least as often as once in every five years, and that evidence of having taken advantage of such opportunities should receive consideration where promotion was in question. During such leave the medical officer should receive full salary without deduction for payment of a sub- stitute, and a grant should be made to cover fees for study. It is possible that such a procedure might require legislative authority, but there appears to be no good reason why the Government should not before now have taken action on the Report of the Committee of Inquiry. The 83 (Dublin) General Hospital. The annual dinner of the Dublin Unit which staffed the 83 General Hospital, B.E.F., in 1917-18, was held last Saturday night in the Council Room of the Royal College of Surgeons, Colonel Sir William Taylor presiding. Some 15 members of the unit were present. SCOTLAND. (FROM OUR OWN CORRESPONDENT.) The New Health Department. THE Scottish Department of Health came into existence on Jan. 1st. The Scottish Board of Health passed out of existence on Dec. 31st. In point of form the Board was a survival from an older and more amateurish conception of Government service. It was essentially an advisory board with no powers

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Page 1: IRELAND

99

murder, manslaughter or infanticide, both before- a coroner, on the one hand, and before examiningjustices and assize courts on the other. The coroner" in the absence of reason to the contrary," is toadjourn his inquest " until after the conclusion ofthe criminal proceedings." The clerk of the appro-priate court is to inform the coroner of the result ofthose proceedings and, if the coroner then decidesnot to resume the inquest, the coroner furnishes theregistrar of deaths with a certificate stating theresult of the proceedings and including any necessaryparticulars. An inquest was begun last year uponthe death of a child. The magistrates committedthe child’s mother to the November Assizes on acharge of wilful murder. The coroner apparentlyadjourned his inquest as directed by the 1926 Act.The next step, however, contemplated by the statutecannot be taken. The Home Secretary has orderedthe woman’s removal to an asylum : she will nownot be tried, and consequently the " proceedings

"

cannot be "concluded " with any " result " of which

the coroner can be officially informed. Thus, it wouldseem, the inquest must take its course. The coronerhas found himself obliged to issue a warrant againstthe mother, bind over the police superintendent toprosecute, and bind over the witnesses to appearand give evidence. It would have been feasible totake the poor woman to the assizes for the formalpurpose of obtaining a verdict of " Guilty, but insane."Quite apart from the expense of this course, however,public opinion would deprecate it.

An Unregistered Dental Association.A case was recently heard before the Oldham

borough justices in which a manager of the Co-operativeWholesale Society (Health Insurance Section) wassummoned for " practising or holding himself out topractise dentistry," his name not appearing in theDentists Register. It was argued on behalf of theBritish Dental Association that it was not essential forthe commission of an offence of this kind, that theperson should be the actual one who performed theoperations of dentistry. A body corporate or limitedcompany could carry on dentistry if the majority ofits directors and all its operating staff were dentists,though not otherwise. It was stated that the C.W.S.,being an approved society under the Health InsuranceActs, had not agreed to an increase in the scale ofdentists’ fees in 1926, and despite the fact that it wasnot a registered organisation under the Dentists Act,had endeavoured to set up dental clinics in certainnorthern towns. An unregistered dental surgeon hadbeen given charge of such a clinic at Oldham wherethere was a clerk and four dental mechanics, andpatients had been treated there on behalf of theCo-operative Dental Benevolent Association, which wasunregistered under the Act. In defence counsel arguedthat responsibility for what had been done lay withthe Association and not with its salaried manager.The chairman and the bench were of opinion, however,that the latter had unlawfully held himself out aspractising dentistry and fined him £50, also awardingJB25 costs to the prosecution. They agreed to state a- case for appeal to the High Court.

Two Deaths Under Ancesthesia.

Arrangements at the Weir Hospital, Balham, werecriticised at an inquest on Jan. 2nd on a boy of 4who died in the institution whilst a fracture of theleg was being reduced under an anaesthetic. Thereare two resident doctors at the hospital but one ofthem was away when the child was brought fortreatment. The resident medical officer first adminis-tered open ether and then instructed a nurse tohold the mask while he reduced the deformity.’Death followed from heart failure, despite employ-ment of artificial respiration and stimulants, and atautopsy it was found that the boy had a full stomachwhich adhered abnormally to the liver. The coroner,m recording a verdict of death by misadventure, saidthat the resident medical officer had exercised carefuljudgment in the circumstances, was justified in

administering the anaesthetic, and did so properly.

At the same time he considered it distinctlv inadvisablethat the hospital should be left with only one doctor,since only in grave emergency should a medical manplay the dual part of anaesthetist and surgeon. Itwas stated in evidence that the hospital had twovisiting surgeons, but it was not customary to callthem in except for big operations.On Jan. 8th the Westminster coroner recorded a

similar verdict in the case of a boy of 2 who diedduring an operation at Charing Cross Hospital.Post mortem large pieces of undigested food werefound in the stomach and the pathologist, in ascribingdeath to syncope, said that the presence of food wasprobably in part responsible for the accident. Themother said she had not received any instructionsabout meals, and the doctor who gave the anaestheticsaid that she (the doctor) had not seen the child onany previous occasion. The anaesthetic was ethylchloride, followed later by a mixture of chloroformand ether. The coroner remarked that he thoughtit was the common practice in hospitals to warnparents not to give their children meals a few hoursbefore anaesthetics would be administered.

IRELAND.

(FROM OUR OWN CORRESPONDENT.)

Study Leave.THE refusal of the Minister of Local Government

and Public Health to sanction the proposal of theGrangegorman Mental Hospital Committee to giveone of their medical officers six months’ study leavewith pay has given rise to criticism. As was pointedout by a member of the committee, the institutionwould benefit by the course of study which Dr. J.Dunne proposed to pursue. Another member men-tioned that the Minister of Defence had thought itwise to send young officers to study the methods offoreign armies.The lack of any provision for study leave is a

grave fault in the public medical services of theIrish Free State. The Committee of Inquiry onNational Health Insurance and the Medical Servicesin its Interim Report in 1925 made a strong recom-mendation in favour of the grant of study leave atregular intervals to dispensary medical officers.It was recommended that a period of not less thanthree months should be given at least as often asonce in every five years, and that evidence of havingtaken advantage of such opportunities should receiveconsideration where promotion was in question.During such leave the medical officer should receivefull salary without deduction for payment of a sub-stitute, and a grant should be made to cover fees forstudy. It is possible that such a procedure mightrequire legislative authority, but there appears tobe no good reason why the Government should notbefore now have taken action on the Report of theCommittee of Inquiry.

The 83 (Dublin) General Hospital.The annual dinner of the Dublin Unit which staffed

the 83 General Hospital, B.E.F., in 1917-18, was heldlast Saturday night in the Council Room of the RoyalCollege of Surgeons, Colonel Sir William Taylorpresiding. Some 15 members of the unit were

present.

SCOTLAND.

(FROM OUR OWN CORRESPONDENT.)

The New Health Department.THE Scottish Department of Health came into

existence on Jan. 1st. The Scottish Board of Healthpassed out of existence on Dec. 31st. In point ofform the Board was a survival from an older andmore amateurish conception of Government service.It was essentially an advisory board with no powers